Impact of body habitus on single-site laparoscopic appendectomy for nonperforated appendicitis: subset analysis from a prospective, randomized trial.
INTRODUCTION: There have been several series documenting the utility of single-site laparoscopic appendectomy. However, there are no data to support patient selection based on their physical characteristics. We recently completed a large prospective, randomized trial comparing single-site laparoscopic appendectomy with standard three-port laparoscopic appendectomy for nonperforated appendicitis. This dataset was used to examine the relative impact of body habitus on operative approach.
SUBJECTS AND METHODS: We performed an analysis of the dataset collected in a prospective, randomized trial of 360 appendectomy patients who presented with nonperforated appendicitis. Body mass index (BMI) was calculated and plotted on a growth chart to obtain BMI percentile according to gender and age. Standard definitions for overweight (BMI 85-95%) and obesity (BMI >95%) were used.
RESULTS: In the single-site group there were 26 overweight and 19 obese patients. In the three-port group there were 25 overweight and 16 obese patients. There were no significant differences between overweight and normal with either approach. However, with the single-site approach there was longer mean operative time, more doses of postoperative narcotics given, longer length of stay, and greater hospital charges in obese patients. In the three-port group, there were no differences between normal and obese patients.
CONCLUSIONS: When using the single-site approach for appendectomy, obesity in children creates longer operative times, more doses of postoperative analgesics, longer length of stay, and greater charges. However, obesity has no impact on three-port appendectomy.
Journal of laparoendoscopic & advanced surgical techniques. Part A
Appendectomy; Appendicitis; Body Mass Index; Child; Female; Humans; Laparoscopy; Length of Stay; Male; Obesity; Overweight; Prospective Studies; Surgical Wound Infection; Treatment Outcome
Appendectomy; appendicitis; Body mass index; obesity; Surgical Wound infection; Treatment outcome
Knott, E. M., Gasior, A. C., Holcomb, G. W., Ostlie, D. J., St Peter, S. D. Impact of body habitus on single-site laparoscopic appendectomy for nonperforated appendicitis: subset analysis from a prospective, randomized trial. Journal of laparoendoscopic & advanced surgical techniques. Part A 22, 404-407 (2012).